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<h4>GEHC Service Center : Contact Us</h4>
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<h5><font color=white>Welcome</font></h5>
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<STRONG>Links to Other Sites</STRONG><br />
<FONT color="#ff0066">&gt;</FONT> <a href="http://www.ge.com">GE Home Page</a><br /><br />
<STRONG>Links</STRONG><br>
<FONT color="#ff0066">&gt;</FONT> <a href=logoff.jsp>Logon</a><br /><br />
<STRONG>Instructor Samples</STRONG><br />
<FONT color="#ff0066">&gt;</FONT> <a href=javascript.jsp>JavaScript Samples</a><br />
<FONT color="#ff0066">&gt;</FONT> <a href=SchoolMascot.htm>School/Mascot</a><br />
<FONT color="#ff0066">&gt;</FONT> <a href=userlist.jsp>User List</a><br /><br />
<STRONG>Workshop Solutions</STRONG><br />
<FONT color="#ff0066">&gt;</FONT> <a href=ServicePlans.htm>Service Plans</a><br />
<FONT color="#ff0066">&gt;</FONT> <a href=ContactUs.htm>Contact Us</a><br />
<FONT color="#ff0066">&gt;</FONT> <a href=ROICalculator.htm>ROI Calculator</a><br />
<FONT color="#ff0066">&gt;</FONT> <a href=ShipCalculator.htm>Shipment Calculator</a><br />
<FONT color="#ff0066">&gt;</FONT> <a href=productlist.jsp>Product List</a><br />
<FONT color="#ff0066">&gt;</FONT> <a href=customerlist.jsp>Maintain Customer</a><br />
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<tr><td colspan=2><br /><h2>How may we help you?</h2><br /></td></tr>
<tr><td colspan=2 style="color:#3B73B9; font-size=12; font-weight:bold;">Do you have a question on GE Healthcare products or services?  If so, please enter your question here...<br /><br /></td>
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<textarea name="CustomerQuestion" rows=3 cols=80></textarea>
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<tr><td><h3>Tell us about yourself...</h3></td></tr>

<tr><td>Work:</td><td><input type=text name=Work size=20><font color="red">*</font></td></tr>
<tr><td>Position:</td><td><input type=text name=Position size=20><font color="red">*</font></td></tr>
<tr><td>First Name:</td><td><input type=text name=FirstName size=20><font color="red">*</font></td></tr>
<tr><td>Last Name:</td><td><input type=text name=LastName size=20><font color="red">*</font></td></tr>
<tr><td>Address:</td><td><input type=text name=Address1 size=20><font color="red">*</font></td></tr>
<tr><td></td><td><input type=text name=Address2 size=20></td></tr>
<tr><td>City:</td><td><input type=text name=City size=20><font color="red">*</font></td></tr>
<tr><td>State:</td><td><input type=text name=State size=20><font color="red">*</font></td></tr>
<tr><td>Zip Code:</td><td><input type=text name=ZipCode size=5><font color="red">*</font></td></tr>

<tr><td>Country ID:</td><td><select name="CountryID">
<option value="0" selected>USA</option>
<option value="19">Belgium (French)</option>
<option value="20">Belgium (Flemish)</option>
<option value="17">Canada</option>
<option value="3">Denmark</option>
<option value="1">Europe</option>
<option value="4">Finland</option>
<option value="5">France</option>
<option value="6">Germany</option>
<option value="22">Greece</option>
<option value="7">Hungary</option>
<option value="8">Israel</option>
<option value="9">Italy</option>
<option value="18">India</option>
<option value="10">Netherlands</option>
<option value="11">Norway</option>
<option value="21">Poland</option>
<option value="12">Spain</option>
<option value="13">Sweden</option>
<option value="15">Turkey</option>
<option value="16">United Kingdom</option>
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<font color="red">*</font></td></tr>
<tr><td>Email Address:</td><td><input type=text name=EmailAddress size=20><font color="red">*</font></td></tr>   
<tr><td colspan=2><input type=submit value="Submit!"><font color="red">Note: An asterisk (*) field is a required field.</font></td></tr>
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